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At least 433 records · Page 24Linked to original sources
PubMed1993

Experimental ileitis in dogs and colitis in rats with trinitrobenzene sulfonic acid--colonoscopic and histopathologic studies.

Using a novel experimental model of chronic enterocolitis described by Morris et al., we observed sequential changes of mucosal lesions endoscopically and performed histopathological studies. Fisher rats were rectally administered 25 mg of trinitrobenzene sulfonic acid (TNBS) dissolved in 0.5 ml of 50% ethanol (ET). The combination treatment of TNBS and ET produced colitis in rats for over 3 weeks. TNBS itself did not induce any lesions. ET alone induced mucosal lesions, but their severity was much smaller than that induced by TNBS/ET. As an animal model much closer to human inflammatory bowel disease, we have newly developed a canine model of chronic ileitis. Adult mongrel dogs were administered 10 ml of 100% ethanol and 1 g of TNBS dissolved in 10 ml of distilled water (i.e., 100 mg/ml solution) through a 4-lumen double balloon tube which was inserted into the ileum. The TNBS/ET-induced ileitis in dogs persisted for 8 weeks. The mucosal lesions induced by TNBS/ET were characterized as annular or longitudinal ulcers accompanied by extensive lymphocyte infiltration and granulomas, which were similar to macro- and microscopic findings observed in human Crohn's disease. Endoscopic examinations were a valuable tool to obtain sequential information on the development of inflammatory changes in each individual animal. Our canine model would provide various advantages for the study of functional impairment in chronic enterocolitis as well as for the detection of potential therapeutic agents in the human counterpart.

Animals↗
PubMed1993

A case of polypoid cavernous hemangioma of the sigmoid colon excised by colonoscopic polypectomy.

A 28-year-old Japanese man was admitted to our institute because of sharp anal pain and a mass that prolapsed from the anus after defecation. After spinal anesthesia for emergency operation, the mass spontaneously withdrew into the anus and the pain disappeared. Surgery was postponed. Barium enema and colonoscopy revealed a pedunculated polyp in the sigmoid colon, which was removed by snare polypectomy with electrocautery. The resected polyp was granular and reddish, and measured 33 x 22 x 14 mm. Histological examination of the polyp revealed a cavernous hemangioma. Hemangioma of the colon is rare; only 52 cases have been reported in Japan. Of these patients, eight underwent endoscopic polypectomy. The present lesion is the largest thus treated that has been documented. Endoscopic polypectomy seems to be a safe and preferable procedure for the diagnosis and treatment of small, solitary polypoid hemangiomas of the colon.

Adult↗
PubMed2003

Staging of colonic neoplasms by colonoscopic miniprobe ultrasonography.

BACKGROUND AND AIMS: In contrast to the situation in the upper gastrointestinal tract staging of colonic neoplasm by endoscopic ultrasonography (EUS) has not gained importance because until yet preoperative staging is without any clinical consequences. This may change with the introduction of minimally invasive surgical procedures and endoscopic resection techniques as an alternative to conventional (open) surgery. PATIENTS AND METHODS: We performed EUS with a miniprobe in 54 consecutive patients with colonic tumors who had been referred to our hospital for endoscopic resection or for laparoscopic resection of their lesions. Therefore patients with locally advanced tumors or systemic tumor spread were not included. After detection of the lesion during colonoscopy miniprobe EUS was performed with water-filling of the colonic lumen. The depth of invasion (T classification) and the local lymph node status (positive or negative) was ascertained. Lymph node-negative lesions staged as T1 underwent endoscopic resection whenever this was technically possible. In lymph node-negative T2-3 tumors laparoscopic resection was planned if they were localized at least 10 cm apart from the flexuras. All other lesions were resected by open surgery. The EUS findings were later compared with the final pathological results (pTN classification) of the resected specimen. RESULTS: In 50 patients (93%) a sufficient EUS evaluation of the colonic tumor was possible. In one patient with a tumor at the left flexura the lesion could not be completely visualized, and in three patients a sufficient water filling of the colon was impossible. The infiltration depth was correctly classified in 17 adenomas, 16 T1, 8 T2, 5 T3, and one T4-carcinoma (EUS accuracy for T staging: 94%). Two T2 and one T3 carcinoma were overstaged by EUS while no understaging was recorded. The lymph node status was correctly classified in 42/50 patients (84%), and a false-negative lymph node status was found in only 4/50 cases (8%). The overall accuracy of EUS was 80%. CONCLUSION: Miniprobe EUS is suitable and has a sufficient but not optimal accuracy for staging of colonic neoplasm. Its employment makes sense if minimally invasive resection techniques in patients with high-risk for open surgery are planned.

Adenoma↗
PubMed2000

Intussusception of the vermiform appendix: preoperative colonoscopic diagnosis of two cases and review of the literature.

Intussusception of the appendix is an uncommon condition, and the diagnosis is rarely made preoperatively. Making an accurate diagnosis before laparotomy is important in providing the optimal treatment for the patient. We present the clinical and endoscopic features of two cases of intussusception of the appendix and review the literature. Diagnosis was made preoperatively by colonoscopy in these cases and an elective appendectomy was performed. Appendiceal intussusception should be considered in the differential diagnosis of abdominal pain. Colonoscopy can be a valuable tool in establishing this diagnosis and in selecting the appropriate management.

Abdominal Pain↗
PubMed1996

Preoperative radiotherapy for resectable cancer of the middle-distal rectum: its effect on the primary lesion as determined by endorectal ultrasound using flexible echo colonoscope.

20 patients with rectal cancer within 8 cm of the anal verge were studied. Endoscopic endosonography was carried out before and after pre-operative radiotherapy (45 Gy over three weeks). The local extent (tumour stage and diameter) was compared with the results of histopathological examination of the resected specimen after anterior resection or total rectal excision. The Tumour Regression Grade (TRG) and lymph node status were also estimated. Two patients were not evaluated endosonographically. Two (11%) of the remaining 18 patients showed ultrasound evidence of down staging (14/18 uT3/4 pre-radiotherapy: 12/18 uT3/4 after) and tumour diameter was significantly reduced. Tumour Regression Grade estimation showed evidence of response to treatment, showing regression of more than 50% in 13 (65%) of cases. Involved nodes were less than 5 mm in diameter in 45% of cases. Histopathological evidence of nodal metastatic regression was seen in 13 (28%) of all involved nodes found. The ultrasonically determined response to radiotherapy may offer useful information in predicting outcome and possibly in selecting surgery.

Adenocarcinoma↗